A 35-year-old patient has been admitted to a hospital for pain in the left sternoclavicular and knee joints, lumbar area. The disease has an acute character and is accompanied by fever up to 38oC. Objectively: the left sternoclavicular and knee joints are swollen and painful. In blood: WBCs - 9, 5x109/l, ESR - 40 mm/h, CRP - 1,5 millimole/l, fibrinogen - 4,8 g/l, uric acid - 0,28 millimole/l. Examination of the urethra scrapings reveals chlamydia. What is the most likely diagnosis?

Correct Answer: A

Rationale: The most likely diagnosis is Reiter's syndrome. This is suggested by the presence of joint pain, fever, elevated ESR and CRP levels, and chlamydia infection. Reiter's syndrome is a reactive arthritis triggered by an infection elsewhere in the body, such as chlamydia. The patient's symptoms of joint pain and swelling, along with the positive chlamydia test, support this diagnosis. Rheumatic arthritis (Choice B) is not associated with chlamydia infection, making it less likely. Gout (Choice C) typically presents with elevated uric acid levels, which are normal in this case. Bechterew's disease (Choice D) primarily affects the spine and sacroiliac joints, not the sternoclavicular and knee joints as seen in this patient.

Correct Answer: A

Rationale: Rationale: - Yersinia enterocolitica is a common cause of diarrhea due to contaminated food or water. - It typically presents with symptoms such as abdominal pain, fever, and diarrhea. - The other choices are unlikely causes of prolonged diarrhea, as Bordetella pertussis causes whooping cough, Neisseria meningitidis causes meningitis, and Corynebacterium diphtheria causes diphtheria.

Correct Answer: B

Rationale: The correct answer is B, Helicobacter pylori. This bacterium is the main cause of peptic ulcers by damaging the protective lining of the stomach and duodenum. It secretes enzymes that weaken the mucosal barrier, allowing stomach acid to cause damage. Salmonella typhi (A) causes typhoid fever, not peptic ulcers. Shigella boydii (C) causes dysentery, not peptic ulcers. Salmonella enterica (D) causes food poisoning, not peptic ulcers. Therefore, the correct answer is B based on its direct association with peptic ulcer formation.

Correct Answer: B

Rationale: The correct answer is B: phase-contrast microscope. This type of microscope is ideal for observing living microorganisms because it enhances the contrast of transparent specimens without the need for staining or fixing, allowing for clear visualization of internal structures and movements. Bright-field microscopes (A) are suitable for observing fixed and stained specimens, not living organisms. Fluorescence microscopes (C) are used to detect specific cellular components tagged with fluorescent markers, not ideal for observing overall morphology. Electron microscopes (D) use electron beams and are best for viewing detailed structures at high magnification, but are not suitable for observing living organisms due to the need for vacuum conditions.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C (Nystatin) is the correct answer: 1. Nystatin is an antifungal medication specifically effective against Candida infections. 2. Candida is a type of fungus, not a bacteria targeted by penicillins (choice A) or cephalosporins (choice B). 3. Nystatin works by disrupting the fungal cell membrane, leading to its death. 4. Choice D (None of the above) is incorrect as Nystatin is a suitable treatment option for Candida infections.

Correct Answer: D

Rationale: The correct answer is D: IgM. IgM antibodies are the first type of antibodies produced by the immune system in response to an acute infection, such as Parvovirus B19. During the first 10-14 days of the infection, IgM antibodies are usually detectable in the blood, indicating a recent or ongoing infection. IgG antibodies (choice A) are produced later in the immune response and indicate past infection or immunity. IgA (choice B) is more commonly associated with mucosal immunity and may not be as prominent in the early stages of systemic infections. IgD (choice C) is primarily found on the surface of B cells and is involved in B cell activation but is not typically used as a marker for acute infections like IgM.

Correct Answer: A

Rationale: The most likely causative agent is Corynebacterium diphtheriae. Step 1: Presence of rod-shaped bacteria indicates a bacillus. Step 2: Polar granules suggest metachromatic granules seen in C. diphtheriae. Step 3: C. diphtheriae causes diphtheria, which presents with sore throat. Summary: B is incorrect as S. pneumoniae is a cocci, not a bacillus. C is incorrect as H. influenzae is a pleomorphic coccobacillus. D is incorrect as K. pneumoniae is a large, encapsulated bacillus.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Clostridium botulinum is known for producing the neurotoxin causing botulism. 2. Botulinum toxin paralyzes muscles, leading to symptoms of botulism. 3. Clostridium tetani produces tetanus toxin causing muscle rigidity, not botulism. 4. Streptococcus pneumoniae causes pneumonia, not botulism. 5. Escherichia coli can cause food poisoning, but not botulism. Summary: Choice A is correct (Clostridium botulinum) due to its association with botulism and neurotoxin production. Choices B, C, and D are incorrect as they are associated with different diseases and toxins.

Correct Answer: A

Rationale: 1. Bordetella pertussis causes whooping cough. 2. It secretes toxins that damage the respiratory tract. 3. Symptoms include severe coughing fits and the characteristic "whoop" sound. 4. Clostridium tetani causes tetanus, not whooping cough. 5. Haemophilus influenzae causes various infections, not whooping cough. 6. Staphylococcus aureus causes skin infections, not whooping cough.